A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control.

BACKGROUND: Historically, the focus of Non Communicable Disease (NCD) prevention and control has been cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), cancer and chronic respiratory diseases. Collectively, these account for more deaths than any other NCDs. Despite recent calls to include the common mental disorders (CMDs) of depression and anxiety under the NCD umbrella, prevention and control of these CMDs remain largely separate and independent. DISCUSSION: In order to address this gap, we apply a framework recently proposed by the Centers for Disease Control with three overarching objectives: (1) to obtain better scientific information through surveillance, epidemiology, and prevention research; (2) to disseminate this information to appropriate audiences through communication and education; and (3) to translate this information into action through programs, policies, and systems. We conclude that a shared framework of this type is warranted, but also identify opportunities within each objective to advance this agenda and consider the potential benefits of this approach that may exist beyond the health care system.

Sustaining dietary changes for preventing obesity and diabetes: lessons learned from the successes of other epidemic control programs

A degree of success has been achieved in controlling several epidemics of infectious and non-infectious causes of death in countries, such as, Australia and New Zealand. Using the epidemiological triad (host, vector, environment) as a model, the key components of the control of these epidemics have been identified and compared to the current status of interventions to prevent obesity and its main disease consequence, type 2 diabetes. Reductions in mortality from tobacco, cardiovascular diseases, road crashes, cervical cancer and sudden infant death syndrome have been achieved by addressing all corners of the triad. Similarly, prevention programs have minimized the mortality from HIV AIDS and melanoma mortality rates are no longer rising. The main lessons learned from these prevention programs that could be applied to the obesity/diabetes epidemic are: taking a more comprehensive approach by increasing the environmental (mainly policy-based) initiatives; increasing the 'dose' of interventions through greater investment in programs; exploring opportunities to further influence the energy density of manufactured foods (one of the main vectors for increased energy intake); developing and communicating specific, action messages; and developing a stronger advocacy voice so that there is greater professional, public and political support for action. Successes in the other epidemics have been achieved in the face of substantial barriers within individuals, society, the private sector and government. The barriers for preventing obesity/diabetes are no less formidable, but the strategies for surmounting them have been well tested in other epidemics.

The long and the short of flagellar length control

Discusses key issues concerning the length control of flagellates. How the cell maintains the consistency of length; Final flagellar length achieved when the rate of flagellar assembly slows down to a point where it exactly balances the rate of flagellar disassembly; Implications on phycology.

Abating the consequences of managerialism on the forgotten employees : the issues of support, control, coping and pay

With the widespread and continuing adoption of managerialism in the public sector, ignoring the impact of change on employees could prevent managerialism from achieving its goals. Subsequently, this study investigates the efficacy of an augmented demand-control-support (D-C-S) model in predicting three of the key employee outcomes in the context of organizational change—psychological health, job satisfaction, and organizational commitment. Analyses of a survey of 207 employees in the Australian public sector, a sector that has undergone, and continues to undergo, substantial change toward managerialism, found that the augmented D-C-S model explained a significant proportion of the employee outcomes in the public sector context. The most important variables were work-based social support and job control. Coping style and perceptions of work conditions, such as pay, were also significant. The augmented D-C-S model provides a useful, proven tool for managers operating within the contemporary public sector.

Using bottlenecks to control production inventory

In this paper, we investigate how to best optimise the level of Production Inventory or Work In Progress (WIP) in a factory. Using a simulation model of the factory, we show that a level of inventory can be optimised by controlling the buffer levels of the key bottleneck workcenters. By firstly identifying the key bottlenecks, and then systematically reducing the maximum buffer level for each bottleneck, results show that the throughput does not drop rapidly from it's high levels until the WIP is halved. Conversely, the production lead time decreases rapidly and levels out around the point of the optimum WIP level.

Ageing effects on knee and ankle joint angles at key events and phases of the gait cycle.

The objective of this research was to determine whether joint angles at critical gait events and during major energy generation/absorption phases of the gait cycle would reliably discriminate age-related degeneration during unobstructed walking. The gaits of 24 healthy adults (12 young and 12 elderly) were analysed using the PEAK Motus motion analysis system. The elderly participants showed significantly greater single (60.3% versus 62.3%, p < 0.01) and double ( p < 0.05) support times, reduced knee flexion (47.7° versus 43.0°, p < 0.05) and ankle plantarflexion (16.8° compared to 3.3°, p = 0.053) at toe off, reduced knee flexion during push-off and reduced ankle dorsiflexion (16.8° compared to 22.0°, p < 0.05) during the swing phase. The plantarflexing ankle joint motion during the stance to swing phase transition (A₂) for the young group (31.3°) was about twice ( p < 0.05) that of the elderly (16.9°). Reduced knee extension range of motion suggests that the elderly favoured a flexed-knee gait to assist in weight acceptance. Reduced dorsiflexion by the elderly in the swing phase implies greater risk of toe contact with obstacles. Overall, the results suggest that joint angle measures at critical events/phases in the gait cycle provide a useful indication of age-related degeneration in the control of lower limb trajectories during unobstructed walking.

Quality of internal control procedures : antecedents and moderating effect on organisational justice and employee fraud

Purpose – This study aims to bring together theoretical concepts from the organizational justice, internal control and fraud literature to develop two distinct models relating to employee fraud and the quality of internal control procedures (ICP), respectively.

Design/methodology/approach – Survey data from 64 Australian firms were used to develop the two models. The first model was tested using a logistic regression analysis, and the second model was tested using a multiple regression analysis.

Findings – The first model reveals that the quality of ICP has a moderating effect on the relationship between perceptions of organizational justice and employee fraud. The second model indicates that ICP quality is significantly and positively related to three key organizational factors: the corporate ethical environment, the extent of risk management training of staff, and the internal audit (IA) activity level.

Practical implications – Risk management strategies relating to employee fraud will need to pay greater attention to organizational factors that affect both perceptions of justice at the workplace and ICP quality, including fostering a more ethical and equitable work environment, increasing IA activities and staff training in risk management.

Originality/value – Using the fraud triangle framework, this study extends previous literature by providing empirical evidence on the role of organizational justice and ICP regarding employee fraud.

Power control in CDMA systems based on channel identification

Power control design is a critical aspect of CDMA cellular systems design. This paper develops an adaptive power controller design method for CDMA systems. The key to the power control design is on the recursive identification of the underlying wireless stochastic channel model parameters. The identification process guarantees the power controller to work well for systems in unknown or time varying network environment.

Intersection of autonomy and social control : negotiating teenage motherhood

Contrary to popular belief, teenage mothers are a declining proportion of birthing women; however they receive much negative public attention. Of particular public concern is the high cost of supporting teenage mothers, in terms of financial, health and welfare resources. Historically, the typical founding mother of white Australia was single, but post-war changes in the family structure incorporated the expectation that children be born into two-parent households with the male as the breadwinner. Policy changes in the seventies saw the introduction of the Sole Parents Pension which meant that many birthing teenage women could choose to keep their infants rather than have a clandestine adoption or an enforced marriage. The parenting practices of teenage mothers have been criticised for being less than optimal, and mother and child are reported as being disadvantaged cognitively, psychosocially, and educationally. One widespread nursing service which provides support for new mothers in Victoria is the Maternal and Child Health Service; however, teenage mothers appear reluctant to use such services. Why this should be so became an important question for this research, since little is known about the parenting practices of teenage mothers. This study therefore sought to explore mothering from the perspective of five sole supporting teenage mothers each of whom had a child over six months of age. The research methodology took an interpretive ethnographic approach and was guided by feminist principles. The data were collected through repeated interviewing, participant observation, informal discussions with key informants, field notes and journalling. Data analysis was aided by the use of the software, program NUD-IST. It was found that the young women in this study each chose to give birth with full realisation that their existence was dependent on the Welfare State. Unanticipated, however, were the many structural barriers which made their lives cataclysmic, but these reinforced their determination to prove themselves worthy and capable mothers. The young women negotiated motherhood through a range of social supports and through maternal practice. Unquestionably, their social dependency on the welfare system forced them into marginal citizen status. Moreover, absolute and intrinsic poverty levels were experienced, brought about by inadequate welfare payments. Formal support agencies, such as the Maternal and Child Health nurses were rarely approached to provide childrearing support beyond the initial months following birthing, since the teenagers' basic needs such as shelter, food and clothing took precedence over their parenting needs. Additionally, some nurses were perceived to hold judgmental attitudes towards teenage mothers. It was far easier to forestall confrontation with nurses and the other 'older' women clientele by avoiding them. Thus XI they turned to charitable agencies who provided a safety net in the form of emergency supplies of money, food, or equipment. Informal networks of friends provided alternative modes of support when family help failed to materialise. The children, however, provided the young women with an opportunity to transform their lives by breaking free of the past, and by creating a new, mature existence for themselves. Despite being abandoned by family, friends, lovers and society, in the privacy and isolation of their own homes, they attempted to provide a more nurturing environment for their children than they themselves had received. Each bestowed unconditional maternal love on the child and were rewarded through the pleasures of watching their children grow and develop into worthwhile individuals. The children became the focus of their attention and their reason for living. In the course of their welfare dependency, the young women became public property, targets of surveillance, and were subjected to stigmatising and condescending public attitudes wherever they went. In this way, it was evident that they were an oppressed group, but each found ways of resisting. Rather than focussing on their oppressive or disabling lives, or dwelling on their disadvantaged status, the young women sought their identities as mature women through motherhood and by demonstrating that they could do this important job well. Through motherhood their lives had meaning and a sense of purpose. The thesis concludes that motherhood in the teenage years is difficult. However, if appropriate supports are made available, teenage mothers need be no different from non-teenage mothers. But with state resources shrinking, and their own resources limited, teenage mothers are disadvantaged. In some ways, this study showed that all levels of support were inadequate, although those provided through the charitable organizations were seen to be the most appropriate. This reflects the current policy of economic rationalism adopted by most Western liberal democracies in the 1980s and 1990s and no less by the former Keating Labor Government in Australia.

General practitioner and the control of sexually transmissible infections

Sexually transmissible infections (STIs), one of the major preventable health problems affecting the Australian population, are often asymptomatic and, if undetected, can cause sub-fertility, infertility and chronic morbidity. In addition to these significant and costly consequences, STIs increase the risk of transmission of HIV. Given that 80% of Australian patients attend their General Practitioner (GP) each year, GPs are well placed to have a significant impact on STI transmission by diagnosing and treating both asymptomatic and symptomatic disease. Good professional practice would suggest that all GPs will undertake certain actions when they are consulted by a patient who either has symptoms of an STI or who appears to be at risk of acquiring an STI. This expectation is based on the premise that all GPs share the same detailed knowledge of STI risk factors and symptoms. It assumes that they will have no difficulty in eliciting such information from the patient, that the patient will comply with STI testing and treatment and that the patient will return for follow-up, to ensure that they and their sexual partners have been adequately treated. Given the constraints of the real world in which general practice exists, the sensitive nature of sexual health, and the stigma associated with STIs, there are many barriers to achieving such an outcome. My own previous research has highlighted some of the difficulties experienced by GPs in the area of STI control. This study has used data from four different sources (policy and stakeholder documents, literature, key informant interviews and my own past research) to examine ideal practice and actual practice in the prevention and treatment of STIs. A number of discrepancies were identified, and from these arose a series of recommendations for ways of making STI control in general practice less complex. To ensure that the results of the study were firmly embedded in the reality of general practice, comments on the recommendations were sought from GPs employed in a variety of practice settings, including those with low STI caseloads. These comments were used to modify the recommendations to ensure they would offer a practical and effective contribution to STI control in Victoria.

Knowledge sharing in professional accountancy firms : the effects of task complexity and management control system

Numerous empirical studies on knowledge management have focused on effectiveness of enablers such as organizational structure (Bennett and Gabriel, 1999; Gold et al., 2001), technology (Gold et al., 2001; O’Dell and Grayson, 1998), culture (DeLong and Fahey, 2000; Gupta and Govindarajan, 2000), managerial system (Nonaka, 1994; Sveiby, 1997) and strategy (Bierly and Chakrabarti, 1996; Holsapple and Joshi, 2001) on knowledge sharing. These enablers are organizational infrastructure or mechanism for facilitating the sharing of knowledge in a firm. In knowledge-intensive firms, task complexity and management control systems (MCS) can potentially affect the mode and effectiveness of knowledge sharing. However, these two factors have not been distinctly and explicitly investigated and discussed in literature relevant to the domain of knowledge sharing and management. This study proposes to examine how task complexity and the design of MCS could be the key determinants of the mode and effectiveness of knowledge sharing in professional accounting firms or practices.

Management control systems use, organisational capabilities and performance in universities: application of the resource-based view

Invoking the resource-based view (RBV), this study investigates relationships between management control systems (MCSs) use, including information use from performance measurement systems (PMSs), and organisational capabilities in the context of academic units of Australian universities. Increased competition and attention to distinctive capabilities amongst universities, particularly at their strategic operating unit level of Schools 1, provides the setting for application of this theoretic perspective. The objective of this study is to model various relationships between diagnostic and interactive use of MCSs, attention given to centrally-imposed and discretionary types of PMS information, the strength of capabilities of the academic unit and, in turn, performance of the academic units. This objective is investigated using a field survey in which a mail survey instrument is administered to a census of all Heads of Schools in all 39 universities in Australia. Valid responses were received from 166 Heads. Principal components factor analysis finds that Heads conceived capabilities of their unit in functional dimensions, not in generic dimensions as found in prior literature; Heads also considered performance measures in terms of their importance (critical or discretionary) rather than type (financial versus non-financial). Partial least-squares analysis is then used for path modelling, and several significant results are obtained. Highlights are that diagnostic MCS use and centrally-imposed performance measures, i.e., key performance indicators, but not interactive MCS use or discretionary performance measures, significantly relate to some or all of the strength of capabilities in the fields of teaching, research and networking, and in turn indirectly relate to performance of the academic units. The findings have practical implications for styles of control systems use; focus on selected key performance measures; and development of organisational capabilities for achievement of superior performance by academic schools in universities.

Use of management control systems in university faculties : evidence of diagnostic versus interactive approaches by the upper echelons

Drawing on upper echelon theory and focusing on the context of higher education reforms in Australia within new public management in university faculties/colleges, this study investigates the diagnostic versus interactive uses of management control systems by Deans/Pro-Vice Chancellors of Faculties/Colleges (hereafter called Faculty PVCs). It seeks to identify how the professional and experiential characteristics of these senior academic executives and the structure of their Faculty, impact on their managerial and collegial orientation as reflected in their approach to using management controls. A mail survey of Faculty PVCs is conducted amongst a census of all Faculties/Colleges of all universities in Australia. Supplementing this survey are semi-structured interviews with the PVC of the business and science Faculty at a large Australian university. Results reveal that PVCs who have had a longer career in higher education tend to use MCSs more interactively (or collegially). There is also evidence that as PVCs hold their current position for longer periods, they tend to move from an early diagnostic use of MCSs to a subsequent interactive use. Further, the higher the complexity of a Faculty the more a PVC will adopt an interactive approach to MCS use. Other PVC and Faculty characteristics did not reveal patterns of significant influence on the interactive or diagnostic use of MCSs. A key revelation from interviews is that PVCs will give over-riding importance to meeting centrally-set diagnostically-focused KPI, but still take a collegial approach within their Faculty to the broader use of MCSs. The findings lend limited support to upper echelons theory, but provide a grounding for further research into the impact that a managerial versus a collegial approach by PVCs/Deans may have on their Faculty’s growth in innovative capacities, teaching qualities or financial strength.

A prospective study on building quality : enforcement of control in the Australian housing industry

The Australian housing industry is beset with quality issues with repeated building defects causing problems with customer satisfaction and housing performance. These defects are caused by a combination of initial poor workmanship and poor quality materials and subsequently by poorly executed or inadequate maintenance. These poor work practices increase the cost and maintenance of housing. The waste and rectification work generated by such practices means that the housing industry generally is not engaged with sustainability. Building Control is part of achieving quality of building output. Whilst the Australian Building Code has regulations for initial-build material quality and workmanship, there is no continuing control and effective enforcement over a house over its life span. Sustainability is not dealt with as a topic at all in the Building Code with only energy efficiency concerns regulated. Inadequate knowledge transfer, to the mainly small builders who produce the majority of Australia’s housing, is seen to be a key issue. Mechanisms to make the transfer of knowledge to those who need to use it need to be improved. Building regulations, for example, could be more visual and accessible in their content and small builders should be encouraged to update their knowledge and skills. This comparative research will guide industry service providers in improving their performance and suggest how overall housing quality can be improved (thereby reducing wasteful practices), by considering more appropriate mechanisms for knowledge transfer among industry service providers in the Australian housing industry.

Integrated modelling of cost-effective siting and operation of flow-control infrastructure for river ecosystem conservation

Wetland and floodplain ecosystems along many regulated rivers are highly stressed, primarily due to a lack of environmental flows of appropriate magnitude, frequency, duration, and timing to support ecological functions. In the absence of increased environmental flows, the ecological health of river ecosystems can be enhanced by the operation of existing and new flow-control infrastructure (weirs and regulators) to return more natural environmental flow regimes to specific areas. However, determining the optimal investment and operation strategies over time is a complex task due to several factors including the multiple environmental values attached to wetlands, spatial and temporal heterogeneity and dependencies, nonlinearity, and time-dependent decisions. This makes for a very large number of decision variables over a long planning horizon. The focus of this paper is the development of a nonlinear integer programming model that accommodates these complexities. The mathematical objective aims to return the natural flow regime of key components of river ecosystems in terms of flood timing, flood duration, and interflood period. We applied a 2-stage recursive heuristic using tabu search to solve the model and tested it on the entire South Australian River Murray floodplain. We conclude that modern meta-heuristics can be used to solve the very complex nonlinear problems with spatial and temporal dependencies typical of environmental flow allocation in regulated river ecosystems. The model has been used to inform the investment in, and operation of, flow-control infrastructure in the South Australian River Murray.